[Remote] Senior Manager Health Care Quality at CVS Health

Connecticut, United States

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Not SpecifiedCompensation

N/AExperience Level

N/AJob Type

Not SpecifiedVisa

N/AIndustries

Requirements

Minimum of 7-10 years of experience in healthcare quality, quality improvement, and performance measurement
Proficiency in Microsoft Office Suite
Demonstrated ability to analyze and interpret complex data sets and convert findings into actionable insights
Excellent time management, planning and organizational skills
Strong written and verbal communication skills
Ability to work independently and collaboratively in a fast-paced environment
Bachelor’s Degree or equivalent experience
Experience presenting to leaders and/or leadership teams (preferred)
Experience with Medicare Stars, HEDIS, or NCQA reporting (preferred)

Responsibilities

Develop the annual quality program (QAPI) trilogy documents (program description, workplan, program evaluation) in compliance with state and federal requirements
Monitor QAPI activities through supporting workplan management
Ensure all Integrated Duals Quality Policies comply with contract requirements
Support internal and external QAPI audits and surveys as needed
Adhere to NCQA standards and work with National Quality Management Accreditation team to maintain the plan's NCQA accreditation as required
Work with key stakeholders and key resources across the Integrated Duals and enterprise to develop, drive and deliver on QAPI program activities and initiatives
Coordinate and implement interventions to increase HEDIS, CAHPS, performance improvement projects and designated health measures to meet contract and plan goals
Prepare and support the development of reports, presentations, and other documentation to communicate QAPI program outcomes and performance monitoring
Develop data sets, KPIs, and other types of needed to execute the QAPI program – ensure data accuracy and integrity to meet internal and regulatory requirements
Assist in evaluating the QAPI program on an ongoing basis and support the QAPI program improvement process

CVS Health

Comprehensive pharmacy and healthcare services

About CVS Health

CVS Health operates a large network of retail pharmacies and walk-in medical clinics across the United States, providing a variety of health-related products and services. Their offerings include prescription medications, over-the-counter health products, and beauty items, as well as pharmacy benefits management and specialty pharmacy services. CVS Health's integrated business model allows them to serve individual consumers, businesses, and communities effectively, with a focus on improving health outcomes and reducing healthcare costs. Unlike many competitors, CVS Health combines pharmacy services with medical care, making it easier for patients to access quality healthcare. The company's goal is to enhance access to healthcare and support individuals in achieving better health.

Woonsocket, Rhode IslandHeadquarters

1963Year Founded

DEBTCompany Stage

Healthcare, Consumer GoodsIndustries

10,001+Employees

Benefits

Health Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

401(k) Retirement Plan

Company Equity

Wellness Program

Professional Development Budget

Paid Vacation

Paid Holidays

Risks

Legal challenges related to opioid prescriptions could harm CVS's reputation and finances.

The DOJ's intervention in a whistleblower lawsuit may increase legal costs for CVS.

The Horizon Organic Milk recall exposes potential vulnerabilities in CVS's supply chain.

Differentiation

CVS Health operates over 9,600 retail pharmacies and 1,100 walk-in clinics nationwide.

The company integrates pharmacy benefits management with specialty pharmacy services for comprehensive care.

CVS Health offers tailored medication plans through personalized medicine and pharmacogenomics.

Upsides

Expansion of telehealth services allows CVS to reach more patients remotely.

Increased consumer interest in wellness boosts demand for CVS's health-related products.

The trend towards value-based care aligns with CVS's integrated healthcare approach.

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